We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us
LGC Clinical Diagnostics

Download Mobile App

Thromboelastometry Predicts Thromboembolic Events in COVID-19 Patients

By LabMedica International staff writers
Posted on 05 Jul 2022
Print article
Image: ROTEM delta analysis helps optimize patient treatment and monitor results. Four channels and a comprehensive reagent portfolio aid in the evaluation of coagulopathies (Photo courtesy of Werfen)
Image: ROTEM delta analysis helps optimize patient treatment and monitor results. Four channels and a comprehensive reagent portfolio aid in the evaluation of coagulopathies (Photo courtesy of Werfen)

In addition to severe pulmonary and renal injury, abnormality of hemostasis is recognized as a contributing factor to the severity of the COVID-19. Thromboembolic complications were diagnosed in 31% of patients with COVID-19 infection admitted to an intensive care unit, despite anticoagulation therapy.

Assessment of hemostasis with traditional plasma coagulation tests (e.g., prothrombin time, activated thromboplastin time) is often not helpful because they evaluate only the initial phase of clot formation and frequently do not demonstrate significant abnormality. Viscoelastic tests (e.g., thromboelastography (TEG), rotational thromboelastometry (ROTEM), or ClotPro) were developed to assess in real time all stages (dynamic) of clot formation and fibrinolysis using whole blood samples.

Clinical Scientists at the Warren Alpert Medical School of Brown University (Providence, RI, USA) and their colleagues carried out a prospective cohort study that included 25 patients and inclusion criteria were a positive PCR COVID-19 test result and respiratory insufficiency requiring supplemental oxygen. The primary outcome was defined as an unfavorable course of the disease if a patient: (1) developed a thromboembolic event while receiving anticoagulation prophylaxis, (2) had prolonged ICU stay, or (3) died.

Rotational thromboelastometry was performed by trained personnel using a ROTEM delta device (TEM Innovations GmbH, Bedford, MA, USA). The following ROTEM tests were performed: (1) EXTEM assay consisting of recombinant tissue factor and Polybrene (heparin inhibitor) added to re-calcified whole blood to activate the extrinsic pathway and initiate coagulation, (2) In the FIBTEM assay, the contribution of platelets to clot formation is eliminated allowing to assess fibrinogen contribution (functional fibrinogen) to hemostasis. It is performed by an addition of recombinant tissue factor, polybrene and platelet inhibitor cytochalasin D added to the whole blood sample to activate the extrinsic pathway while suppressing platelets.

The investigators reported that there were 16 patients with an unfavorable course of the disease. Compared to the nine patients in the favorable course group, patients with an unfavorable course had a lower platelet count, median difference of 154 × 109/L (95% CI, 26 to 223 × 109/L), and lower clot firmness parameters in EXTEM assay: amplitude at 20 minutes (A20), median difference of 7, maximum clot firmness (MCF), median difference of 6 and area under the curve (AUC) with a median difference of 671. They also demonstrated suppression of fibrinolysis: higher lysis index 60, median difference of − 3. Results of functional fibrinogen (FIBTEM) assay were similar between the groups.

The authors concluded that the platelet count and the results of EXTEM assay, but not FIBTEM assay, were associated with the difference in clinical outcome among patients with COVID-19 infection and hypoxemia. The study was published on June 28, 2022 in the Journal of Blood Medicine.

Related Links:
Warren Alpert Medical School of Brown University 
TEM Innovations GmbH

Platinum Supplier
SARS-CoV-2 Reactive & Non-Reactive Controls
Qnostics SARS-CoV-2 Typing
Gold Supplier
COVID-19 NAb Test Solution
COVID-19 NAb Test Solution
Benchtop Shakers
Innova 40 and 40R
Cystatin C POC Test
Cystatin C Assay

Print article


Clinical Chemistry

view channel
Image: The new assays are designed to run on the B•R•A•H•M•S KRYPTOR compact PLUS clinical chemistry analyzer (Photo courtesy of Thermo Fisher)

Breakthrough Immunoassays to Aid in Risk Assessment of Preeclampsia

Preeclampsia is a life-threatening blood pressure condition that can arise during pregnancy and the postpartum phase. This severe pregnancy complication is a primary cause of maternal and fetal mortality... Read more

Molecular Diagnostics

view channel
Image: The ClarityDX Prostate test can reduce unnecessary prostate biopsies by up to 35% (Photo courtesy of Nanostics)

Innovative Blood Test to Revolutionize Prostate Cancer Detection and Reduce Invasive Biopsies

One in six men will receive a prostate cancer diagnosis during their lives. Thankfully, if caught early, prostate cancer is highly treatable. However, the existing screening process has its limitations.... Read more


view channel
Image: The latest FDA clearance has finally brought HemoScreen to its full potential as a true POC hematology analyzer (Photo courtesy of PixCell)

True POC Hematology Analyzer with Direct Capillary Sampling Enhances Ease-of-Use and Testing Throughput

An innovative 5-part differential Complete Blood Count (CBC) analyzer with direct capillary sampling capability significantly simplifies blood sampling and minimizes the pre-analytical process.... Read more


view channel
Image: A new test could detect the body’s adaptive immune response to viruses (Photo courtesy of 123RF)

Predictive T-Cell Test Detects Immune Response to Viruses Even Before Antibodies Form

The adaptive immune system is an incredible defense mechanism that allows the human body to identify and mount targeted responses against specific pathogens. T-Cells, a special kind of white blood cell,... Read more


view channel
Image: On-chip pretreatment and rapid AST based directly on positive blood cultures (Photo courtesy of Liu Yang)

Integrated Solution for Rapid AST Directly From Positive Blood Cultures to Combat Bloodstream Infection

The presence of living bacteria in the bloodstream, known as bacteremia, can lead to serious conditions like bloodstream infections (BSIs) and sepsis, which can often be fatal. Quickly prescribing the... Read more


view channel
Image: The Mitotic Counting algorithm was trained on over 100,000 individual mitosis and across seven scanner models (Photo courtesy of Gestalt Diagnostics)

New AI Algorithm for Use on Eight Types of Cancer Trained on Seven Scanner Models

A new artificial intelligence (AI) algorithm for use on one of the broadest trained environments is now available for commercial or research work. Gestalt Diagnostics (Spokane, WA, USA) has released the... Read more


view channel
Image: A new electrochemical device can quickly and inexpensively identify people at greatest risk for osteoporosis (Photo courtesy of ACS Central Science, 2023)

Electrochemical Device Identifies People at Higher Risk for Osteoporosis Using Single Blood Drop

With the global increase in life expectancy, the incidence of age-related conditions like osteoporosis is increasing. Osteoporosis, affecting around 200 million individuals worldwide, has a higher incidence... Read more


view channel
Image: AACC Middle East is a two-day conference that brings the latest in laboratory medicine to the Middle East region (Photo courtesy of ADLM)

AACC Middle East 2023 to Explore Latest Trends in Clinical Pathology and Laboratory Medicine

The AACC Middle East Conference and Exposition will be held by the Association for Diagnostics & Laboratory Medicine (ADLM - formerly AACC, Washington, DC, USA) in partnership with Life Dx (Abu Dhabi,... Read more
Copyright © 2000-2023 Globetech Media. All rights reserved.